Healthcare Provider Details

I. General information

NPI: 1740680750
Provider Name (Legal Business Name): DR. KAYLEIGH ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KAYLEIGH DARLING

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 W BAY AREA BLVD # 111
WEBSTER TX
77598-4100
US

IV. Provider business mailing address

563 W BAY AREA BLVD # 111
WEBSTER TX
77598-4100
US

V. Phone/Fax

Practice location:
  • Phone: 409-761-1145
  • Fax: 281-822-7370
Mailing address:
  • Phone: 409-761-1145
  • Fax: 281-822-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number69120
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: